Drinking flood contaminated water causes

With the city of Corpus Christi and surrounding areas hit hard last week with heavy rain, health officials are warning about an increased risk of illnesses and hazards that can be caused by the rising floodwaters.

Just walking through flood waters can expose you to all sorts of infection and diseases.

Floodwater is more than simple rain. It’s often contaminated with sewage and chemicals and can hide sharp objects. And it can also carry diseases.

“It’s the fact that you can be walking through actual human waste and infect some of those germs. A lot of them are E. coli, salmonella and shigella; hepatitis A virus; and all this you can get an infection from, especially if you are not careful about cleanliness, hand washing, and avoiding drinking water while you are outside in the street,” said Amistad Community Health Center Dr. Jacqueline Phillips.

The skin is the biggest barrier to infection, and the risk of infection is greater if one has open wounds.

“Usually it takes several days for you to develop any type of symptoms,” Phillips said. “So it is safe to say, that about a week to 10 days after exposure would be when you would start to see symptoms of infection for E. coli, salmonella, shigella, and hepatitis A. You need to watch out for fevers and chills, nausea, vomiting, diarrhea, as well as abdominal pain.”

One of the best ways to protect yourself after a major flood is to maintain good hygiene.

“If you happen to be caught in a flood, or you feel you have been exposed to anything, it is always important to make sure hygiene is the number one preventive measure that you can take to prevent infection,” Phillips said. “So hand washing, making sure whatever water you’re walking in or drinking or utilizing has been properly treated and clean.”

Floods typically flush out mosquitoes and interrupt their breeding cycle, but when the flooding stops, it’s what the floods leave behind that is often just as dangerous as what is in the water.

“Any area with standing water is a breeding ground for mosquitoes, and this increases everyone’s possible exposure to West Nile Virus and/or Zika,” Phillips said.

Flooding can cause the disruption of water purification and sewage disposal systems, overflowing of toxic waste sites and dislodgement of chemicals previously stored above ground.

Although most floods do not cause serious outbreaks of infectious disease or chemical poisonings, they can cause sickness in workers and others who come in contact with contaminated floodwater.

In addition, flooded areas may contain electrical or fire hazards connected with downed power lines.

Floodwater often contains infectious organisms, including intestinal bacteria such as E. coli, salmonella, and shigella; hepatitis A virus; and agents of typhoid, paratyphoid and tetanus.

The signs and symptoms experienced by the victims of waterborne microorganisms are similar, even though they are caused by different pathogens.

These symptoms include nausea, vomiting, diarrhea, abdominal cramps, muscle aches and fever. Most cases of sickness associated with flood conditions are brought about by ingesting contaminated food or water.

Tetanus, however, can be acquired from contaminated soil or water entering broken areas of the skin, such as cuts, abrasions or puncture wounds.

Tetanus is an infectious disease that affects the nervous system and causes severe muscle spasms, known as lockjaw.

The symptoms may appear weeks after exposure and may begin as a headache, but later develop into difficulty swallowing or opening the jaw.

Floodwaters also may be contaminated by agricultural or industrial chemicals or by hazardous agents present at flooded hazardous waste sites.

Flood cleanup crew members who must work near flooded industrial sites also may be exposed to chemically contaminated floodwater. Although different chemicals cause different health effects, the signs and symptoms most frequently associated with chemical poisoning are headaches, skin rashes, dizziness, nausea, excitability, weakness and fatigue.

Pools of standing or stagnant water become breeding grounds for mosquitoes, increasing the risk of encephalitis, West Nile virus or other mosquito-borne diseases.

The presence of wild animals in populated areas increases the risk of diseases caused by animal bites (e.g., rabies) as well as diseases carried by fleas and ticks.

Protect yourself after a major flood, it is often difficult to maintain good hygiene during cleanup operations.

To avoid waterborne disease, it is important to wash your hands with soap and clean, running water. Do it especially before work breaks, meal breaks and at the end of the work shift.

Workers should assume that any water in flooded or surrounding areas is not safe unless the local or state authorities have specifically declared it to be safe.

If no safe water supply is available for washing, use bottled water, water that has been boiled for at least 10 minutes or chemically disinfected water. (To disinfect water, use 5 drops of liquid household bleach to each gallon of water and let sit for at least 30 minutes for disinfection to be completed.)

Water storage containers should be rinsed periodically with a household bleach solution. If water is suspected of being contaminated with hazardous chemicals, cleanup workers may need to wear special chemical protective outer clothing and goggles.

Before entering a contaminated area that has been flooded, you should don plastic or rubber gloves, boots, and other protective clothing needed to avoid contact with floodwater.

Decrease the risk of mosquito and other insect bites by wearing long-sleeved shirts, long pants, and by using insect repellents.

Wash your hands with soap and water that has been boiled or disinfected before preparing or eating foods, after using the bathroom, after participating in flood cleanup activities, and after handling articles contaminated by flood waters.

In addition, children should not be allowed to play in flood waters or with toys that have been in contact with flood waters. Toys should be disinfected.

What to do if Symptoms Develop If a cleanup worker experiences any of the signs or symptoms listed above, appropriate first-aid treatment and medical advice should be sought.

If the skin is broken, particularly with a puncture wound or a wound in contact with potentially contaminated material, a tetanus vaccination may be needed if it has been five years or more since the individual’s last tetanus shot.

When to go to the ER, Tips to Remember

Before working in flooded areas, be sure your tetanus shot is current (given within the last 10 years). Wounds that are associated with a flood should be evaluated for risk; a physician may recommend a tetanus immunization.

Consider all water unsafe until local authorities announce that the public water supply is safe.

Do not use contaminated water to wash and prepare food, brush your teeth, wash dishes or make ice.

Keep an adequate supply of safe water available for washing and potable water for drinking.

Be alert for chemically contaminated floodwater at industrial sites.

Use extreme caution with potential chemical and electric hazards, which have great potential for fires and explosions. Floods have the strength to move and/or bury hazardous waste and chemical containers far from their normal storage places, creating a risk for those who come into contact with them. Any chemical hazards, such as a propane tank, should be handled by the fire department or police.

If the safety of a food or beverage is questionable, throw it out.

Hurricanes can cause fierce winds, torrential rain, and flooding, sending hundreds of thousands of people fleeing from their homes. And even after the immediate dangers of drowning or being swept away have passed, storms can also create dangerous conditions that last long after the wind and rain have stopped.

In addition to the health risks associated with power outages and damaged plumbing, floodwater itself can harbor bacteria and disease-carrying organisms that pose a risk to evacuees, rescue workers, and anyone returning to their homes after a hurricane.

“Floodwater can have very high levels of bacteria, viruses, sewage, and parasites that can infect you if it gets in your mouth, your eyes, or into a cut in your skin,” says Amesh Adalja, MD, an emergency medicine doctor and senior scholar at the Johns Hopkins University Center for Health Security. “It’s much different than other types of water you’d encounter in everyday life.” Here are a few of the ways that flooding can make disaster victims and rescue workers sick, and how you can protect yourself if you’re in harm’s way.

One of the biggest risks of swallowing floodwater is ingesting a bacterium, virus, or parasite that causes a gastrointestinal illness, says Dr. Adalja. “Most of these infections will probably be pretty benign and may only cause vomiting or diarrhea,” he says. But these symptoms can also become serious and can cause life-threatening dehydration.

Cryptosporidium, Giardia, E. coli, and salmonella are a few examples of germs that can contaminate floodwater and cause stomach distress. Leptospirosis, a potentially fatal illness that’s spread through rat urine, is another big risk in flooded communities, says Dr. Adalja. Experts also warn about cholera and typhoid fever, both of which can be caused by bacteria-contaminated water after natural disasters and flooding.

Swallowing bacteria isn’t the only risky thing about being exposed to floodwater. “People in these situations may have abrasions or cuts on their body, and those can get secondarily infected with bacteria from the water,” says Dr. Adalja. In 2017, a Texas woman died weeks after falling into floodwaters during Hurricane Harvey and contracting necrotizing fasciitis, also known as flesh-eating bacteria.

Most of the 37 fatalities related to Hurricane Florence involved vehicles caught in floodwaters, but "deaths related to storm clean-up have been reported," according to a statement released by the North Carolina governor's office. (Phelps, who doctors tried to save by amputating his infected leg, was one of those reported fatalities.) "Residents should wear gloves and proper protective clothing while doing storm clean-up work and wash any cuts or scrapes thoroughly to prevent infection," the statement advises.

“If you have cuts or scrapes, try your best to cover them up and administer basic first aid,” Dr. Adalja agrees. “Use an antibiotic ointment if you have it, and keep an eye on it to make sure it doesn’t become red or swollen.” If it doesn’t appear to be healing like it should—or if you develop a fever, chills, or other signs of infection—see a doctor as soon as you can.

“Another problem with flooding is that it can attract mosquitoes,” says Dr. Adalja. “They find breeding places in all the debris that serves as receptacles for standing water after a flood.” Most of the country is at risk for West Nile Virus, says Dr. Adalja, and several states can also harbor mosquitoes that carry Zika virus, dengue fever, and chikungunya.

In the aftermath of Hurricane Florence, residents working outdoors are being advised to use insect repellant or wear long sleeves to avoid mosquito bites. The governor of North Carolina also made $4 million in funds available for mosquito control in flooded areas.

Hepatitis is often thought of as an illness that’s spread through sex or IV drug use, but certain types of the disease can also be transmitted through contaminated food or water. Hepatitis A and E, specifically, can be a danger in areas that have experienced flooding, although hepatitis E is rare in the United States.

The bacteria Legionella is found naturally in water, and when people swallow or breathe in contaminated water droplets, they can contract Legionnaires’ disease—a respiratory infection that causes coughing, shortness of breath, fever, and chills. Like most bacterial infections, Legionnaires’ disease can usually be treated with antibiotics—although it can sometimes be fatal, especially if it's not caught early.

Legionnaires’ disease is often spread when a supply of drinking water becomes contaminated, or through contaminated pools or hot tubs. But there have also been documented cases of people becoming sick with the disease after cleaning up floodwater.

In the midst of a natural disaster, it can be hard to avoid exposure to flooding—and to find appropriate medical treatment immediately afterward. But Dr. Adalja says that people can reduce their risk of becoming sick by using common sense and trying to practice good hygiene whenever possible.

“Try to avoid exposure of your mouth, your nose, and your eyes to the water if you can,” he says. “And of course, avoiding floodwater altogether is the safest bet, which is why evacuation is usually the best thing to do.” If you do get sick after exposure to floodwater, mention your symptoms to a doctor as soon as you’re able.

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